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MMM Dorado Platino (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MMM Dorado Platino (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MMM Dorado Platino (HMO D-SNP) in 2026, please refer to our full plan details page.
MMM Dorado Platino (HMO D-SNP) is a HMO D-SNP plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Puerto Rico Northwest. This plan received an overall rating of 5 out of 5 stars in 2026.
It's important to know that MMM Dorado Platino (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
MMM Dorado Platino (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MMM Dorado Platino (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For MMM Dorado Platino (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $100.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The MMM Dorado Platino (HMO D-SNP) Medicare plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered medications before your plan begins to pay its share. Understanding this upfront cost is a key factor when estimating your overall healthcare expenses with this plan. Specific details regarding drug coverage tiers, copayments, and coinsurance rates are currently not available for this plan. To get a complete picture of your potential medication costs, you may want to verify how your specific prescriptions are categorized under the plan's formulary.
Additional Benefits
The MMM Dorado Platino (HMO D-SNP) offers comprehensive coverage with no copays and no coinsurance for most essential medical services. This includes inpatient and outpatient hospital stays, primary and specialist doctor visits, emergency care, and preventive services. Patients can also access diagnostic tests, home health, and skilled nursing facility services without any copayments or coinsurance, though prior authorization is required for many of these benefits. In addition to core medical coverage, this plan provides valuable supplemental benefits with no copay, no coinsurance, and no deductibles. Members receive up to $750 annually for vision eyewear, up to $1,500 per year for select dental services, and up to $2,500 every three years for prescription hearing aids. The plan also covers up to 12 one-way transportation trips per year to plan-approved locations and provides worldwide emergency care with a $75 copay.
Inpatient Hospital See details
MMM Dorado Platino (HMO D-SNP) partially covers inpatient hospital services, offering acute and psychiatric hospital stays with no copay and no coinsurance, subject to prior authorization. Under this plan, upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under the MMM Dorado Platino (HMO D-SNP) are covered with no copay and no coinsurance for outpatient hospital, ambulatory surgical center, and outpatient blood services. Some outpatient substance abuse services are covered with no copay and no coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial hospitalization services are covered under the MMM Dorado Platino (HMO D-SNP) plan with no copay and no coinsurance, though prior authorization and a referral are required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by MMM Dorado Platino (HMO D-SNP) with no copay and no coinsurance, though some ambulance services are covered as ground and air ambulance services are not covered. Transportation is covered for up to 12 one-way trips per year to plan-approved health-related locations, while trips to any health-related location are not covered.
Emergency Services See details
MMM Dorado Platino (HMO D-SNP) covers emergency and urgently needed services with no copay and no coinsurance. Worldwide emergency and urgent services are partially covered up to a $500 maximum with a $75 copay and no coinsurance, but worldwide emergency transportation is not covered.
Primary Care See details
MMM Dorado Platino (HMO D-SNP) offers primary care, specialist, therapy, and telehealth services with no copay and no coinsurance. Routine chiropractic and podiatry care are covered with annual limits, though other chiropractic services, along with individual and group sessions for mental health and psychiatric services, are not covered.
Preventive Services See details
MMM Dorado Platino (HMO D-SNP) covers preventive services with no copay and no coinsurance, although prior authorization is required for certain benefits. This coverage is partially covered, as it excludes services such as annual physical exams, in-home safety assessments, personal emergency response systems, and medical nutrition therapy.
Hearing Services See details
Hearing services are partially covered by MMM Dorado Platino (HMO D-SNP) with no copay, no coinsurance, and no deductible, though prior authorization is required. While one fitting evaluation per year and prescription hearing aids up to a $2,500 maximum every three years are covered, routine hearing exams, OTC hearing aids, and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
MMM Dorado Platino (HMO D-SNP) provides partially covered vision services with no copay, no coinsurance, and no deductible, although prior authorization is required. Covered eyewear includes contact lenses and eyeglasses (lenses and frames) up to a $750 annual limit, but routine eye exams, other eye exam services, individual eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
MMM Dorado Platino (HMO D-SNP) partially covers dental services with no copay and no coinsurance up to a $1,500 annual limit, though prior authorization is required. Covered benefits include Medicare-covered dental, restorative services, implants, adjunctive general services, and prosthodontics, while preventive care (including exams, cleanings, and x-rays), endodontics, periodontics, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
MMM Dorado Platino (HMO D-SNP) partially covers home infusion bundled services with no copay and no coinsurance, though prior authorization and step therapy are required. While Medicare Part B insulin drugs are covered with no copay and no coinsurance, Medicare Part B chemotherapy, radiation, and other Part B drugs are not covered.
Dialysis Services See details
Dialysis services are covered under the MMM Dorado Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by MMM Dorado Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required for durable medical equipment. For diabetic equipment and non-Medicare prosthetics and medical supplies, some services are covered, but prosthetic devices, medical supplies, diabetic supplies, and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by MMM Dorado Platino (HMO D-SNP) with no copay and no coinsurance, but prior authorization is required. While some services are covered, diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient x-ray services are not covered.
Home Health Services See details
MMM Dorado Platino (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by MMM Dorado Platino (HMO D-SNP) with no copay and no coinsurance, though only some services are covered as cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by MMM Dorado Platino (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. This benefit is partially covered as additional days beyond those covered by Medicare are not covered, but the plan does allow SNF admission without a prior three-day inpatient hospital stay.
Other Services See details
MMM Dorado Platino (HMO D-SNP) covers acupuncture, over-the-counter items, and meal benefits for chronic illnesses with no copay and no coinsurance. Prior authorization and referrals are required for some of these services, while Naloxone and other miscellaneous services are not covered.
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